Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $622.04 / $1,212.26 / $17,100.00	Facility		$622.04	$1,212.26	$17,100.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $466.54 / $674.71 / $909.20	Facility	54	$466.54	$674.71	$909.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.95 / $622.04 / $1,212.26	Professional		$425.95	$622.04	$1,212.26
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,431.46 / $4,554.63 / $11,500.00	Facility		$2,431.46	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $788.49 / $1,414.67 / $1,414.67	Facility	54	$788.49	$1,414.67	$1,414.67
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $657.01 / $1,048.25 / $3,860.85	Professional		$657.01	$1,048.25	$3,860.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $1,985.59	Facility		$625.25	$761.81	$1,985.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $468.25 / $842.33 / $1,470.32	Professional		$468.25	$842.33	$1,470.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $446.40 / $878.41 / $1,490.07	Facility		$446.40	$878.41	$1,490.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $441.96 / $877.25 / $1,383.48	Professional		$441.96	$877.25	$1,383.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $288.17 / $982.27	Professional		$73.20	$288.17	$982.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $639.05 / $883.73 / $979.54	Facility		$639.05	$883.73	$979.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $639.64 / $1,613.81	Facility		$537.44	$639.64	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $668.13 / $997.61 / $1,240.73	Professional		$668.13	$997.61	$1,240.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,953.48 / $4,552.03 / $8,712.50	Facility		$2,953.48	$4,552.03	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $641.12 / $901.20 / $1,205.85	Professional		$641.12	$901.20	$1,205.85
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $569.00 / $780.11 / $1,391.27	Professional		$569.00	$780.11	$1,391.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $406.37 / $485.63 / $539.69	Professional		$406.37	$485.63	$539.69